Making plans

Why news of higher Obamacare premiums shouldn’t worry women

Nearly 95 percent of women enrolled under the Affordable Care Act qualify for subsidies, with U.S. taxpayers picking up the difference

Many health insurers have increased the prices of their plans, after losing money in the first two years of the new system. (Joe Raedle/Getty Images)

Women receiving healthcare under President Obama’s Affordable Care Act may see the prices of their plans increase this year, but health experts warn that enrollees shouldn’t be spooked by the jump in price tag.

More than three-quarters of women receive enough government subsidies, paid for by taxpayers, that they likely won’t have to pay any more money for the same level of care, they say.

Enrollment in government healthcare plans opened this week, kicking off the third year of so-called Obamacare, and the first year in which many health insurers have increased the prices of their plans after losing money in the first two years of the new system.

Prices jumped an average of 7.5 percent across the states that participate in the exchange, according to the Obama administration. The Wall Street Journal reported Monday that that health insurers lost an average of $163 per customer enrolled under the ACA in 2014, and are trying to adjust their business models accordingly.

But because many of the individuals who get their insurance through the health exchange are already low-income and the cost of their plans is therefore subsidized by the government, any increase in price will likely be passed on to taxpayers and footed by the federal government in the form of subsidies to customers.

“The subsidies really do make a big difference,” said Alina Salganicoff, director of women’s health policy at the Kaiser Family Foundation. “Because the Affordable Care Act includes subsidies and protections, women and men would’ve otherwise been much more exposed.”

In fact, data compiled by Kaiser found that on average, customers will see a slight decrease in the amount they pay for premiums in 2015, despite the overall cost increase of the plans. While prices may go up as much as 10 percent, the average customer will pay nearly one percent less.

“Those increases in premiums are all being absorbed by federal government,” Karen Davenport, Director of Health Policy at the National Women’s Law Center, told Women in the World.

Nearly 95 percent of women enrolled in the health exchange have a low enough income, less than 400 percent of the poverty level, to qualify for a tax credit to help pay for the premiums, Salganicoff said. And three-quarters of of those receive additional cost protections to help with deductibles and co-pays.

Those who make more than 400 percent of the poverty level typically have access to employer-offered healthcare plans, Davenport said. “The uninsured population is a disproportionately low-income one,” she said.

Both Salganicoff and Davenport encouraged women to shop carefully for affordable plans, noting that just because the plan they had last year increased in price doesn’t mean there aren’t cheaper options available this year.

“It’s very important to shop around. The plan you had last year may not be the best plan for this year,” Salganicoff said.

“If you’re window shopping on healthcare.gov, you’re seeing the premium prices without (government) help. So people shouldn’t get sticker shock,” Davenport said.

Still, there are millions of women who have not enrolled and choose not to enroll in the healthcare exchange because it is too costly, a problem which Cynthia Pearson, executive director of the National Women’s Health Network, says should be addressed at the policy level.  “Overall the ACA has made a big difference for women. That said it’s not as affordable as it needs to be,” Pearson said.

She would like to see a cheaper plan offered throughout the country with premiums as low as $20 a month for extremely low-income individuals. New York has already offered such a plan she says is helping more women sign up for coverage. “If it were fully implemented in all 50 states it would have potential of affecting millions of women,” she said.

More than 12 million women are uninsured, the majority of which are likely to be lower income, Hispanic, African-American, and living in the south, according to Salganicoff.

For those who don’t enroll in an insurance plan, penalties will also be higher this year, doubling from $325 to $695, though those who cannot afford to enroll or pay the penalty can apply for a hardship exemption, the number of which Davenport said she expects will increase this year.

The enrollment period for the health exchange runs from November 1 to January 1, 2016, for coverage throughout 2016. Plans can be found on www.healthcare.gov.

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